Cristian Baicus, Caterina Delcea, Larisa Pinte, Gheorghe Andrei Dan
{"title":"COVID-19 - mARN疫苗接种后的高度炎症:处于多系统炎症性疾病和成人发病斯蒂尔氏病的十字路口术语重要吗?","authors":"Cristian Baicus, Caterina Delcea, Larisa Pinte, Gheorghe Andrei Dan","doi":"10.2478/rjim-2021-0035","DOIUrl":null,"url":null,"abstract":"As the pandemic evolves, different facets of the SARS-CoV-2 infection, as well as immunization, with varying complexity and prognostic implications are discovered. One of them is the multisystem inflammatory syndrome (MIS)[1]. Characterized by elevated ferritin levels and hyper-inflammation with vital implications, MIS was proposed as the fifth clinical entity to constitute the “hyperferritinaemic syndromes”, alongside the macrophage activation syndrome (MAS), adult-onset Still’s disease (AOSD), catastrophic anti-phospholipid syndrome and septic shock [2]. Although most reports were related to SARS-COV-2 infection, MIS was recently described in relation to COVID-19 vaccination as well [3]. We hereby report the case of a previously healthy 22-year-old male, who received the first dose of BNT162b2 vaccine on May 1 2021. Thirteen days after vaccination, he developed a hyperinflammatory state, fulfilling the criteria for adult multisystem inflammatory syndrome (MIS-A) [2] (fever, sore throat, myalgias, myocarditis, hepatic injury, maculo-papular rash, diarrhoea, hypotension, and highly elevated inflammatory markers including a procalcitonin level of 33 ng/ml). He was initially admitted in another hospital’s Cardiology department with a diagnosis of acute coronary syndrome. At that moment the patient presented with chest pain, ST elevation on ECG, high troponin level, segmental left ventricular hypokinesia, and mid-range ejection fraction. The coronary angiography was normal,","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"19","resultStr":"{\"title\":\"Hyper-inflammation after COVID-19 mARN vaccination: at the crossroads of multisystem inflammatory disease and adult-onset Still's disease. Does terminology matter?\",\"authors\":\"Cristian Baicus, Caterina Delcea, Larisa Pinte, Gheorghe Andrei Dan\",\"doi\":\"10.2478/rjim-2021-0035\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"As the pandemic evolves, different facets of the SARS-CoV-2 infection, as well as immunization, with varying complexity and prognostic implications are discovered. One of them is the multisystem inflammatory syndrome (MIS)[1]. Characterized by elevated ferritin levels and hyper-inflammation with vital implications, MIS was proposed as the fifth clinical entity to constitute the “hyperferritinaemic syndromes”, alongside the macrophage activation syndrome (MAS), adult-onset Still’s disease (AOSD), catastrophic anti-phospholipid syndrome and septic shock [2]. Although most reports were related to SARS-COV-2 infection, MIS was recently described in relation to COVID-19 vaccination as well [3]. We hereby report the case of a previously healthy 22-year-old male, who received the first dose of BNT162b2 vaccine on May 1 2021. Thirteen days after vaccination, he developed a hyperinflammatory state, fulfilling the criteria for adult multisystem inflammatory syndrome (MIS-A) [2] (fever, sore throat, myalgias, myocarditis, hepatic injury, maculo-papular rash, diarrhoea, hypotension, and highly elevated inflammatory markers including a procalcitonin level of 33 ng/ml). He was initially admitted in another hospital’s Cardiology department with a diagnosis of acute coronary syndrome. At that moment the patient presented with chest pain, ST elevation on ECG, high troponin level, segmental left ventricular hypokinesia, and mid-range ejection fraction. The coronary angiography was normal,\",\"PeriodicalId\":21463,\"journal\":{\"name\":\"Romanian Journal of Internal Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2022-03-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"19\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Romanian Journal of Internal Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2478/rjim-2021-0035\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/3/1 0:00:00\",\"PubModel\":\"Print\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Romanian Journal of Internal Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2478/rjim-2021-0035","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/3/1 0:00:00","PubModel":"Print","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Hyper-inflammation after COVID-19 mARN vaccination: at the crossroads of multisystem inflammatory disease and adult-onset Still's disease. Does terminology matter?
As the pandemic evolves, different facets of the SARS-CoV-2 infection, as well as immunization, with varying complexity and prognostic implications are discovered. One of them is the multisystem inflammatory syndrome (MIS)[1]. Characterized by elevated ferritin levels and hyper-inflammation with vital implications, MIS was proposed as the fifth clinical entity to constitute the “hyperferritinaemic syndromes”, alongside the macrophage activation syndrome (MAS), adult-onset Still’s disease (AOSD), catastrophic anti-phospholipid syndrome and septic shock [2]. Although most reports were related to SARS-COV-2 infection, MIS was recently described in relation to COVID-19 vaccination as well [3]. We hereby report the case of a previously healthy 22-year-old male, who received the first dose of BNT162b2 vaccine on May 1 2021. Thirteen days after vaccination, he developed a hyperinflammatory state, fulfilling the criteria for adult multisystem inflammatory syndrome (MIS-A) [2] (fever, sore throat, myalgias, myocarditis, hepatic injury, maculo-papular rash, diarrhoea, hypotension, and highly elevated inflammatory markers including a procalcitonin level of 33 ng/ml). He was initially admitted in another hospital’s Cardiology department with a diagnosis of acute coronary syndrome. At that moment the patient presented with chest pain, ST elevation on ECG, high troponin level, segmental left ventricular hypokinesia, and mid-range ejection fraction. The coronary angiography was normal,